Seven regional health information exchanges in the upper Midwest are continuing efforts to advance record exchanges between the organizations.

Since last fall, the HIEs have been working to complete technical connections, as well as settling on appropriate legal agreements to permit data exchange, executives say.

In addition, the participating organizations are working to implement a virtual integrated patient record that would enable physicians outside of the five states covered by the HIEs to access patient records if they are needed for treating patients.

Participating HIEs include:

  • Indiana Health Information Exchange, Indianapolis.
  • HealthLINC, Bloomington, Ind.
  • Michiana Health Information Network, South Bend, Ind.
  • East Tennessee Health Information Exchange, Nashville.
  • The Health Collaborative, Cincinnati.
  • The Kentucky Health Information Exchange, Frankfort.
  • Great Lakes Health Connect, Grand Rapids, Mich.

Last October, the HIEs agreed to exchange patient data among themselves to ensure that when individuals traveled to a neighboring state their health information would be available.

The initiative, called the Heartland Project, is fueled with a $270,000 grant from the Department of Health and Human Services, with funds being shared among all seven entities as well as a shared governance structure.

Great Lakes Health Connect, a health information exchange the State of Michigan since 2010, was the last to join. Since April, Great Lakes has received 10,057 admit/discharge/transfer messages and has sent 57,690 such messages to partnering HIEs.

“Heartland Project is seven HIEs working among ourselves with the goal of broadening beyond our regions when patients go outside these areas,” says Doug Dietzman, executive director at Great Lakes Health Connect.

Doug DietzmanWith the use of the virtual integrated patient record, a patient from Michigan and receiving care in another state is identified, and an admit/discharge/transfer message for the patient is transmitted to Great Lakes Health Connect, and the patient’s physician notified.

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With all participating HIEs now live on the system, work now is starting on developing a query process for Continuity of Care Documents, with hopes that CCDs can be exchanged by year-end.

The new seven-HIE data exchange service has been named the Patient-Centered Data Home, with each patient having a data home of information that can be given to a physician to support a complete medical record, Dietzman says.

As technical work progressed in recent months to link the HIEs, so did work to develop policies and procedures governing the actual exchange of data across the region. It took three or four months of work to develop a trust framework governing information that will be shared commonly and how participants will handle the information once they have it, Dietzman says.

One big challenge was managing patient identities, which was handled by running admit/discharge/transfer messages through a master patient index (MPI) to identify patients, and each HIE has its own technology vendors, so they also have their own MPIs and a unique identifier for each patient.

The long-term intent of Heartland Project is to be a model for other HIE initiatives, Dietzman says, but how to do that isn’t yet clear, he acknowledges. But the ultimate goal is quite bigger—to tie all HIEs at some point across the nation.

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